Volume 4
Number 1 January 2020Post-operative Outcome of Acute Sigmoid Volvulus
DOI: https://doi.org/10.70357/jdamc.2020.v0401.05
Rahman M M1 , Rahman M M2 , Uddin M B3 , Qaiyum M A4 , Akter H5
Abstract
Background: Sigmoid volvulus is a common surgical emergency in many regions of the world, with significant morbidity and mortality. Volvulus occurs when a segment of the colon twists about its mesentery. In developing countries it is a major cause of colonic obstruction. The sigmoid colon is involved in up to 90% of cases. It can be present as acute, sub-acute or chronic obstruction. Emergency operation is needed in acute sigmoid volvulus. Various operative methods are used in the management.
Objective: The purpose of this study was to compare the 'primary resection and anastomosis' with 'Hartmann's procedure' for management of acute sigmoid volvulus.
Methods: This comparative cross-sectional study was conducted in a consecutive series of 63 patients, admitted to three different Medical Colleges from February 2012 to December 2018 with acute sigmoid volvulus. Then laparotomy were carried out in all 63 patients. Primary resection of the affected sigmoid colon with anastomosis were done in 37 patients and the Hartmann's procedure performed in 26 patients in two different groups. Outcome of the two procedures analyzed in terms of mortality and post-operative complications.
Conclusion: This study demonstrated that outcome of two procedures are same. Primary resection and anastomosis should be done in uncomplicated acute sigmoid volvulus safely, but in case of complicated patients Hartmann's procedure is the choice of operation.
Keywords: Hartmann's procedure, Primary resection and anastomosis, Sigmoid volvulus, Laparotomy
- Associate Professor, Department of Surgery
- Associate Professor, Department of Surgery
- Assistant Professor, Department of Paediatrics
- Senior Consultant (Surgery)
- Assistant Professor, Department of Onchology